Personalized and Precision Medicine Journal

Abstract Introduction: Regarding to ethnicity and racial complexity in socially heterogeneous and refugee-accepting countries, family approach for organ donation request from a deceased donor could be unpredictable. The problem could be settled by adherence to coordinator-donor conformity rule besides principals of donor family care. Methods: In our OPU, we have recruited a considerable quantity of organ donation coordinators (mainly medical students) with different ethnicities, dialects, and personality types. In this study, we have assessed family approach success indices in two different eras (Before 2017 and after this time). These included overall family consent and refusal rates, time interval from the first interview to actual donation, the weight of different age clusters in the donor pool and etc. Results: Considerable progress was achieved in all family approach success indices. Overall family consent rate was found to be increased from 61% in the first era to 88% in the second era (P = 0.005). The mandatory time for the coordinators to obtain family consent dropped significantly. (12.2 ± 8.6 to 6.3 ± 4.8 Hr, P = 0.02). Furthermore, the weight of precious young donors (< 40 years) increased from 36% to 47% (P = 0.05) due to more success rate in more difficult young cases. Conclusions: Appropriate recruitment of organ donation coordinators warranties more successful organ donation efforts after proper training. Decision making about suitable usage of every coordinator in a specific part of the family approach stages should be done case-by-case. This strategy could be of great benefit in ethnicity and cultural variant communities.

Abstract Nowadays, there has been a considerable advance of personalized medicine on a
scientific basis and clinical demands in cardiovascular diseases. This study investigated
a history of coronary artery bypass graft surgery a strong determinant of inferiority of
organ in cadaveric liver donation. In this study, fate of 14 potential deceased liver
donors with a history of coronary artery bypass graft surgery has been investigated.
This report shows that careful gross and microscopic investigation of the liver is the
key to extract suitable life savior livers from donors with advanced age.

Abstract Introduction: One of the possibilities is the utilize of personalized medicine, a method based on quantifiable and theoretical agents that assign the worldwide immunological hazard of refusal for each patient. Kidney transplantation is the best treatment for end-stage renal disease patients. Although the shortage of kidneys for transplantation has been addressed by expanding the criteria, transplantation teams in Iran don’t have great tendency to implant marginal organs from brain death donors specially the ones with high creatinine before harvesting. The aim of this study was to evaluate the impact of brain dead donor serum creatinine (Cr) level on outcome of transplanted kidneys. Methods: In this retrospective study, the records of 46 brain-dead donors of Masih Daneshvari organ procurement unit of Tehran, Iran were assessed. The medical file of donated 58 recipients was available. Donor demographic data (age, sex), brain death cause and the Cr level after transferring to OPU ICU were recorded. The Cr level was categorized based on ≥1.4 mg/dl with origin of prerenal azotemia or lower. The urine output of transplanted patients in the first 24 hours post-transplant, serum Cr level at discharge from hospital and dialysis during first month after transplantation were compared between two groups. Results: The mean age of donors was 37yr and 25 (54%) were male. The cause of brain death in 16 (35%) was trauma. The donors’ creatinine level at the admission to the ICU was 1.4mg/dl or higher in 20 (35%). The first 24 hours urine output did not significantly differ between donors’ creatinine level lower than 1.4mg/dl or higher (5500 ± 2678ml and 4068 ± 3399ml, respectively, P=0.083). Similarly the recipient discharge serum Cr level did not significantly differ between two groups (1.69 ± 0.97 and 1.74 ± 1.34 mg/dl, respectively, P=0.887). Overall 8 recipients (14%) needed dialysis during first month after transplantation and there was no significant difference between groups (11% and 20%, respectively, P = 0.320).
Conclusions: Findings of this preliminary study showed that the outcome of transplanted kidneys from brain-dead donors with Cr level >=1.4mg/dl is similar to other patients. So, higher creatinine level is not a good excuse for rejecting the kidneys for transplantation. Because of various confounding factors in the assessment of transplanted kidney outcome, the future studies with larger sample size and longer follow-up period is recommended.